The most prevalent mental disorders afflicting women are anxiety and affective disorders, while common health risk behaviors include alcohol and drug use, smoking, and obesity-related behaviors. Sexual minority women (SMW;lesbians, bisexual women, and other women who partner with women), who constitute an estimated 4-5% of the U.S. population of women, are at particular risk for these adverse outcomes. For example, SMW are up to three times more likely to experience depression, up to two times more likely to smoke, and up to three times more likely to be overweight compared to their heterosexual counterparts. Indeed, this population has been acknowledged as at risk for health disparities in Healthy People 2010. Researchers have hypothesized that the elevated rates of mental disorders and health risk behaviors among SMW are linked to the individual and cultural oppression experienced by this population. However, this "minority stress" hypothesis has not been adequately examined in empirical studies of women, in part due to the lack of a gender-sensitive model and instrument to assess SMW's specific concerns. Research on the impact and nature of minority stressors in this population is desperately needed in order to design prevention interventions. To this end, the proposed mixed-methods study will examine associations among minority stress and health outcomes of SMW. Specifically, the qualitative phase will use three focus groups of 24 SMW to provide a description of the novel category "gender expression" and explore its relation to health outcomes and who may be at greatest risk. The quantitative phase will investigate a theoretical model of the effects of gender expression and minority stressors on the outcomes of mental health (i.e., depression, anxiety) and health risk behaviors (i.e., alcohol and drug use, smoking, obesity-related behaviors). Minority stressors we will study include bias-related victimization, stigma consciousness, concealment, internalized homophobia, and internalized sexism. Quantitative data will be collected in a national web-based survey of 200 ethnically diverse SMW. The applicant, who is a top student at a highly ranked clinical psychology program, has outlined an extensive and detailed research plan for the project. Moreover, she has assembled a team of experts in this area who are well situated to mentor her and assist in achieving the project goals.